Neurodevelopmental Outcomes in Infants With Cardiac Surgery Associated Acute Kidney Injury

BACKGROUND Infants who undergo surgery for congenital heart disease are at risk of neurodevelopmental delay. Cardiac surgery-associated acute kidney injury (CS-AKI) is common but its association with neurodevelopment has not been explored.METHODS This was a single-center retrospective observational study of infants who underwent cardiac surgery in the first year of life who had neurodevelopmental testing using the Bayley Scale for Infant Development, third edition. Single and recurrent episodes of stages 2 and 3 CS-AKI were determined.RESULTS Of 203 children with median age at first surgery of 12 days, 31% had one or more episodes of severe CS-AKI; of those, 16% had recurrent CS-AKI. Median age at neurodevelopmental assessment was 20 months. The incidence of delay was similar for patients with and patients without CS-AKI but all children with recurrent CS-AKI had a delay in one or more domains and had significantly lower scores in all three domains, namely, cognitive, language, and motor.CONCLUSIONS This study has assessed the association of CS-AKI with neurodevelopmental delay after surgery for congenital heart disease in infancy. Infants who have recurrent CS-AKI in the first year of life are more likely to be delayed and have lower neurodevelopmental scores.(Ann Thorac Surg 2022;114:2347-55)(c) 2022 by The Society of Thoracic Surgeons

Automated summary

This study explores the association between cardiac surgery-associated acute kidney injury (CS-AKI) and neurodevelopmental delay in infants undergoing surgery for congenital heart disease. Infants with recurrent CS-AKI in the first year of life are more likely to experience delays in neurodevelopment and have lower scores in cognitive, language, and motor domains.